Unstable osteochondral fragment of the lateral femoral condyle containing the popliteus tendon origin. Report of three cases

Abstract

We report a series of three cases of unusual locations of chronic osteochondral fragments arising from the posterolateral aspect of the lateral femoral condyle, presenting acutely in young adults, in which the unstable fragment contained the origin of the popliteus tendon, with MRI and arthroscopic correlation. Although atypical, we hypothesize that these cases represent adult osteochondritis dissecans with extension to a popliteus tendon origin. Preoperative diagnosis of popliteus tendon involvement may influence clinical management in patients with an unstable osteochondral fragment in this location.

Isolated femoral avulsion of the popliteus tendon: a systematic review of the literature

“…Chheda et al present three unusual case of popliteus tendon avulsions occuring in chronic osteochondral lesions of the posterolateral femoral condyl 12 . In all three cases ligamentous examination was normal and the fragment exhibited signs of an acute presentation of a chronic lesion.…”

“…Ligamentous instability during clinical examination is rare in these injuries, however few studies have a long follow-up (mean follow-up 7 months) and progressive instability may be an issue in these injuries. Some authors advise operative repair of isolated popliteus tendon avulsions without further mentioning instability or presence of a fragment [7][8][9][10][11][12][13][14][15][16] . Others advise conservative treatment if no instability is present [17][18][19] .…”

“…A systematic review of the literature was performed according to the Preferred Reporting Items for System-instability or presence of a fragment [7][8][9][10][11][12][13][14][15][16] . Others advise conservative treatment if no instability is present [7][8][9][10][11][12][13][14][15][16][17][18][19] . One authors clearly states that in absence of instability, conservative treatment is an option but repeat clinical examination is a must 20 .…”